GI21 - Evaluation of Intestinal Barrier Dysfunction in Dogs with Acute Hemorrhagic Diarrhea Syndrome

Abstract: Background: Acute hemorrhagic diarrhea syndrome (AHDS) is characterized by the occurrence of acute bloody diarrhea. Histopathologic examination of intestinal biopsies from dogs with AHDS typically reveals necrotizing enteritis. Therefore, the presence of intestinal barrier dysfunction is suspected, which might be associated with clinical severity.


Hypothesis: Dogs with AHDS have increased intestinal permeability, which is associated with clinical severity.


Animals: Thirty client-owned dogs with AHDS and 25 healthy control dogs (HC).


Methods: Prospective clinical trial. The AHDS-index was evaluated in all dogs at the day of presentation. On the same day, dogs were administered 2 ml/kg of iohexol orally. After two hours, serum was obtained to measure iohexol concentration (SIC) by enzyme-linked immunosorbent assay. The same procedure was performed in the HC group. A Mann-Whitney test was used to compare SIC between AHDS and HC. The association between the AHDS-index and SIC was evaluated using Spearman’s rank correlation.


Results: SIC were significantly higher (p = 0.002) in AHDS (median: 46 µg/ml; min-max: 9-246) compared to HC (30 µg/ml; 11-57). There was a significant positive correlation between AHDS-index and SIC (r_s = 0.4; p = 0.020). Furthermore, SIC was significantly higher (p = 0.001) in dogs with severe (AHDS-index ≥ 9) (median: 80 µg/ml; min-max: 25-246) compared to dogs with mild to moderate disease (AHDS-index < 9) (31 µg/ml; 9-54).


Conclusions and clinical importance: Dogs with AHDS have significantly increased intestinal permeability as assessed by iohexol. In addition, a significant correlation between clinical severity and permeability was detected.